Cervical Cancer Screening in Developing Countries

Lazcano‐Ponce, Eduardo; Moss, Sue; Ruı́z, Patricia Alonso de; Castro, Jorge Salmerón; Ávila, Mauricio Hernández

doi:10.1016/s0188-0128(99)00006-8

Cited by 125 publications

(31 citation statements)

References 51 publications

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“…Introducing such efficiently organized population-based cervical cancer screening programmes will require substantial resources and could be a challenging task. Cervix screening programmes in many Latin American countries did not have any impact on cervical cancer burden despite several rounds of intervention since the 1970s and many of them have recently reorganized their screening programmes7071. Even in high-resourced settings, a screening programme takes a minimum of 10-15 yr to evolve.…”

Section: Is Human Papillomavirus Vaccination Relevant To India?mentioning

confidence: 99%

Current global status & impact of human papillomavirus vaccination

Sankaranarayanan¹,

Bhatla²,

Basu³

2016

Indian Journal of Medical Research

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This review addresses the effectiveness and safety of human papillomavirus (HPV) vaccines, the current status of its introduction in the National Immunization Programmes (NIPs) and its relevance to India, which contributes a fifth of the global burden of cervical cancer. The vast literature on efficacy, acceptability and safety of HPV vaccination and its impact after population level introduction was reviewed and discussed. The efficacy of HPV vaccines in preventing high-grade precancerous lesions caused by vaccine-targeted HPV infections was 90 per cent or higher in HPV naïve women in randomized clinical trials. Two doses at 6 or 12 months apart are recommended for 9-14 yr old girls and three doses over six months to one year period for those aged above 15 yr. More than 80 countries or territories have introduced HPV vaccination in their NIPs, of which 33 are low- and middle-income countries (LMICs); in addition, 25 LMICs have introduced pilot programmes before a phased national expansion. Significant reductions in the frequency of HPV 16 and 18 infections, genital warts and cervical premalignant lesions in vaccinated cohorts and herd immunity in general populations have been reported from countries that introduced vaccination in NIPs as early as 2007. More than 280 million doses of HPV vaccines have been administered worldwide with the excellent safety profile with no serious adverse events linked to it. The high burden of cervical cancer and the high efficacy and safety of HPV vaccination justify its introduction in the Indian NIP at the earliest possibility to substantially reduce the cervical cancer burden in future.

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Section: Is Human Papillomavirus Vaccination Relevant To India?mentioning

confidence: 99%

Current global status & impact of human papillomavirus vaccination

Sankaranarayanan¹,

Bhatla²,

Basu³

2016

Indian Journal of Medical Research

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“…Although there has been a national cervical cancer screening program in Mexico since 1974 [1], and despite technological and scientific advances, this disease is the second leading cause of death due to cancer for Mexican women [2]. A recent study that evaluated the effect of the national cervical cancer screening program in Mexico reports that there has been a modest but significant decrease in mortality due to this cancer [3].…”

Section: Introductionmentioning

confidence: 99%

HPV testing for cervical cancer screening appears more cost-effective than Papanicolau cytology in Mexico

Flores

Bishai

Lörincz

et al. 2010

Cancer Causes Control

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ObjectiveTo determine the incremental costs and effects of different HPV testing strategies, when compared to Papanicolau cytology (Pap), for cervical cancer screening in Mexico.MethodsA cost-effectiveness analysis (CEA) examined the specific costs and health outcomes associated with (1) no screening; (2) only the Pap test; (3) only self-administered HPV; (4) only clinician administered HPV; and (5) clinician administered HPV plus the Pap test. The costs of self- and clinician-HPV testing, as well as with the Pap test, were identified and quantified. Costs were reported in 2008 US dollars. The health outcome associated with these screening strategies was defined as the number of high-grade cervical intraepithelial neoplasia or cervical cancer cases detected. This CEA was performed using the perspective of the Mexican Institute of Social Security (IMSS) in Morelos, Mexico.ResultsScreening women between the ages of 30–80 for cervical cancer using clinical-HPV testing or the combination of clinical-HPV testing, and the Pap is always more cost-effective than using the Pap test alone.ConclusionsThis CEA indicates that HPV testing could be a cost-effective screening alternative for a large health delivery organization such as IMSS. These results may help policy-makers implement HPV testing as part of the IMSS cervical cancer screening program.

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“…Health care access and socioeconomic barriers may also limit overall screening coverage and contribute to disparities among population subgroups. A woman’s ability and decision to receive screening may depend on her knowledge about Pap smears, health care access, socioeconomic status, and educational levels (11, 12, 15–17). Two studies in particular—one in Nicaragua, and another in Argentina—found that health care access was independently predictive of having had a recent Pap smear after adjusting for socioeconomic status (12, 16).…”

mentioning

confidence: 99%

Socioeconomic determinants of cervical cancer screening in Latin America

Soneji¹,

Fukui²

2013

Rev Panam Salud Publica

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Objective To assess the impact of health care access and socioeconomic determinants on Pap smear screening in Latin America. Methods Individual-level data was collected from the Demographic and Health Surveys in Bolivia, Brazil, Dominican Republic, Ecuador, Guatemala, Nicaragua, Peru, and Trinidad and Tobago between 1987 and 2008. Multivariate logistic regression analyses were used to identify socioeconomic and health care determinants of two outcomes: knowledge of Pap smears and recent Pap smear screening. Results In all countries, the proportion of women with a recent Pap smear screening remained below 55%. Key determinants of knowledge of Pap smears were age, education, and recent doctor’s visit. For recent Pap smear screening, key determinants were wealth and recent doctor’s visit. Women were between 1.47 and 3.44 times more likely to have received a recent Pap smear if they had a recent doctor’s visit. Even the poorest women with a recent doctor’s visit were more likely to screen than the richest women without a recent visit. Conclusions These data suggest that visiting a doctor is an important determinant of cervical cancer screening in Latin America. Because screening may coincide with other medical visits, physicians could effectively encourage screening.

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Cervical Cancer Screening in Developing Countries

Cited by 125 publications

References 51 publications

Current global status & impact of human papillomavirus vaccination

Current global status & impact of human papillomavirus vaccination

HPV testing for cervical cancer screening appears more cost-effective than Papanicolau cytology in Mexico

Socioeconomic determinants of cervical cancer screening in Latin America

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